Anderson Dermatology and Skin Surgery Center

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER

Practice address

1501 N Main St
Anderson, SC 29621-4734

Phone

(864) 716-0063

Fax

(864) 716-0073

NPI assigned

Nov 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Theresa G Knoepp, M.D.NPI 1073562690

Title

Owner

Phone

(864) 716-0063

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/14194f57-1cf1-4d77-801e-4659b5b99d4c/

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Anderson Dermatology and Skin Surgery Center

  • Dermatology Physician
  • Easley, SC
  • NPI 1790340750
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Greene Knoepp, M.D.

  • Dermatology Physician
  • Anderson, SC
  • NPI 1073562690
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine R Shew, M.D.

  • Dermatology Physician
  • Anderson, SC
  • NPI 1902029382
  Medicare reassignment Care Compare group NPD
• Caroline Pruitt Brown, PA

  • Medical Physician Assistant
  • Anderson, SC
  • NPI 1407815384
  Medicare reassignment Care Compare group
• Stephanie Kirby Davis, PA-C

  • Physician Assistant
  • Anderson, SC
  • NPI 1033402151
  Medicare reassignment Care Compare group
• Claire Gillespie Duke, PA

  • Medical Physician Assistant
  • Greenville, SC
  • NPI 1114431822
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467527150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N MAIN ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214734",
            "telephone_number": "864-716-0063",
            "fax_number": "864-716-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N MAIN ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214734",
            "telephone_number": "864-716-0063",
            "fax_number": "864-716-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNOEPP",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-716-0063",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anderson Chiropractic, LLC (Healthsource of Anderson)
• Anderson Community Healthcare, LLC (Linley Park Post Acute)
• Anderson County Disabilities and Special Needs Board (Inspire Abilities of Anderson County)
• Anderson County Disabilities and Special Needs Board (Inspire Abilities of Anderson County)
• Anderson County EMS
• Anderson Diagnostic Imaging, LLC (Anderson Radiology)
• Anderson Diagnostic Imaging, LLC (Anderson Radiology)
• Anderson ENT, PA
• Anderson Eye & Ear Associates, P.a. (Medicus)
• Anderson Eye Associates, PA

• Dermatology Physician in Anderson, SC
• Providers in Anderson, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.